The following are excerpts and links to excellent articles on Health Care Fraud from:
New Medicare Fraud: “Spinning” Blood at HIV Clinics
June 11, 2009
"DOJ recently busted a Miami, FL-based ring who fraudulently bilked taxpayers by “spinning” patients’ blood to falsify lab results, fooling CMS into paying for otherwise unnecessary meds at HIV infusion clinics. The scheme consists of: (1) obtaining vials of blood drawn from clinic patients; (2) placing the vials in a blood centrifuge; and (3) rotating the blood in the centrifuge for about 15 minutes, causing the blood to separate into its component parts. When sent for lab analysis, the tainted blood makes it appear that otherwise healthy blood has dangerously low platelet counts, which would justify the billing of Medicare for expensive HIV treatments. More than $20M was fraudulently billed before the fraud was discovered. . . " Read More
Jury Says Lousianna Doc Performed Unneccesary Surgeries; Colleagues Say Medicare Got Bill
June 11, 2009
"Dr. Mehmood M. Patel was sentenced to 10 years in prison after a conviction for health care fraud, reports the FBI. The allegations were levied by Patel’s colleague, Dr. Christopher Mallavarapu, who has also filed a qui tam whistleblower lawsuit under the False Claims Act, alleging that Patel fraudulently performed unnecessary surgeries and caused false claims to be submitted to the U.S. by hospitals in Lousianna. According to the FBI, “Testimony from experts in cardiology specialties revealed that the defendant deployed stents, balloons, and radiation in coronary arteries that had little or insignificant disease. . . " Read More
Hawaii Whistleblower Suits Settle; U.S. Recovers $2.5M
June 11, 2009
Queen’s Medical Center of Honolulu paid $2.5 million to settle two whistleblower lawsuits alleging that it overbilled Medicare, Medicaid, and TRICARE. Two former pharmacy techs alleged that the private hospital fraudulently billed for services to residents without the level of supervision required by federal rules.
According to the United States Attorney for the District of Hawaii: (1) QMC submitted false claims to Medicare, Medicaid and TRICARE for anti-psychotic drugs ordered by a psychiatrist which were really ordered by non-psychiatrist physicians without the prior knowledge of a psychiatrist . . . " Read More
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